New Heights

Academic Registration And Tuition Form

August 1, 2025 to July 31, 2026

Tuition Cost
The cost for tuition is $85 per week. Tuition is due before the start of each week. A 10% discount is given when tuition is paid in the amount of 4 weeks at a time.

There is 20% family discount when two or more siblings are registered for classes between Pre-K to 12th grade.

Please make payments payable to New Heights.

Please list Name and Grade Level of each student and siblings who are registering for the Academic Program.

Name____________________________________________ Grade_________

Put a check mark here _______ if you listed additional siblings on the back side of this form.

Parents/Guardian Information:

Name: ________________________________ Relationship___________

Home Phone __________________ Cell Phone ____________________

Email: _____________________________________________________

Name: ________________________________ Relationship___________

Home Phone __________________ Cell Phone ____________________

Email: _____________________________________________________

Permission and Release of Liability:

Medical Release: In the event that Student suffers sudden illness, accident,

or injury, and I (Parent/Guardian of Participant) am not available and cannot be

contacted, I give permission that medical and emergency personnel be

contacted to provide medical and emergency treatment for Participant. I

understand that I am fully responsible for any and all cost for medical and

emergency treatment.

List pertinent medical information or physical limitations below

and alert administrators and teacher of any serious ailments or concerns (diabetes,

allergies, asthma, etc.):

Expectations For Students & Parents/Guardians:

Students and parents/guardians are expected to promote

good character at all academic classes, events, and activities.

Birth Certificates: New Heights does not keep copies of birth certificates on file.

Parents and Guardians are to maintain a copy of a birth certificate for the Student

and be willing to provide a birth certificate if one is ever needed for age verification.

By signing this form, you are agreeing to all the statements listed above,

including, but not limited to, release of liability and medical treatment.

Please Sign and Date:

_________________________________________ _______________

Parent/Guardian Signature Date

_________________________________________ _______________

Parent/Guardian Signature Date